Healthcare Provider Details

I. General information

NPI: 1326063470
Provider Name (Legal Business Name): KRISTI WATSON KELLEY PHARMD, BCPS, BCACP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 08/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 PRINCETON AVE SW STE 229
BIRMINGHAM AL
35211
US

IV. Provider business mailing address

1141 LAKE COLONY LN
VESTAVIA HILLS AL
35242-7424
US

V. Phone/Fax

Practice location:
  • Phone: 205-783-3505
  • Fax:
Mailing address:
  • Phone: 205-967-6140
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number14210
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: